Medication Adherence Management Service (MAMS)

As the average life expectancy increases, the incidence of chronic diseases and number of individuals requiring multiple medications also increases.  Nonadherence with prescription medication remains a contributing factor in poor patient outcomes, including drug misadventures (nonadherence resulting in hospitalizations, emergency room visits, etc.).  These poor outcomes can have extensive medical and economic consequences. It has been estimated that 23% of nursing home admissions are due to nonadherence, as well as 10% of hospital admissions.  The number of different medicines taken is consistently associated with nonadherence.

Clients in the Community Long Term Care (CLTC) elderly/disabled waiver are nursing home eligible but desire to stay in their own homes and receive waivered services through the SC Department of Health and Human Services (DHHS).  CLTC clients take an average of 9.5 medications, indicating that they are at high risk of nonadherence and subsequent hospitalization and nursing home admission. The SC DHHS Division of Community Long Term Care wishes to reduce these risks for their clients.

The SC DHHS has requested that the Office for the Study of Aging (OSA) evaluate a medication adherence management program in a sample of CLTC elderly/disabled waiver clients as a potential service for this waiver population.  This program, the Medication Adherence Management Service (MAMS), proposes to improve adherence, reduce avoidable hospitalizations and nursing home admissions, and thereby address the problem of spiraling healthcare expenditures. OSA is measuring the effectiveness of MAMS by examining four outcome variables: 

• hospitalization rate
• emergency department utilization
• nursing home admission
• total health care cost

The evaluation will also:

• identify risk factors for drug misadventures--to be able to provide a tool for case managers to identify clients who might benefit from the intervention as a waiver service.
• evaluate the service that addresses drug misadventures--to determine if it is cost effective as a waiver service; maintains teh client's quality of life; and reduces total health care costs

The Office for the Study of Aging is currently conducting the data analysis for the evaluation.  For more information about the MAMS project, please contact:

Marcia Lane, MPH
Office for the Study of Aging
Arnold School of Public Health
University of South Carolina
Mlane@sc.edu
(803) 777-5334